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Children's Hospital Boston Physician Surgical Specialty Coder in Boston, Massachusetts

71734BRJob Posting Title:Physician Surgical Specialty CoderDepartment:Shared Service CenterAutoReqId:71734BRStatus:Full-TimeStandard Hours per Week:40 Job Posting Category:FinanceJob Posting Description:To be considered a qualified candidate, you must be a seasoned and strong surgical coder with an understanding of CCI edits and guidelines along with all the surgical modifiers, teaching attestations, global periods, and experience writing appeals and NOC letters. Surgical coder candidates should have the skillset to work independently on their assigned surgical specialties. Additionally, work collaboratively with team members to cross-train and assist in other surgical specialties.

The Physician Specialty Coder will be responsible to:

  • Perform ICD-10 review and complex CPT Coding Validation or ASA coding for assigned surgical specialty departments.

  • Establish and maintain working relationships with Physicians to communicate and resolve specific case issues, as well as general questions and or coding principles.

  • Develop and maintain professional skills. Participate in professional organizations and stay abreast of the latest relevant literature and resources.

  • Remain current on coding and reimbursement rules, with an up-to-date knowledge of regulatory and compliance issues related to coding, documentation, and billing trends and developments.

  • Act as a resource for the Shared Service Center, providing assistance with complex billing/coding systems and payment issues.

  • Provide instruction and education to coworkers on accurate charge entry and medical record documentation.

  • Perform other tasks and projects, as requested, including procedural documentation, and participation in quality and operational improvement processes.

  • Maintain credentials and certifications for CPC on an annual basis

To qualify, you must have:

  • High School diploma or equivalent and min of 2 years of experience in Physician coding with specific experience in Surgical CPT Coding Validation in a specialty or multi-specialty setting is required. Knowledge of coding requirements for services furnished in a teaching setting is preferred. An associate's degree is preferred.

  • Certified Professional Coder (CPC) certification required

  • Knowledge of medical terminology, anatomy and physiology, pathophysiology, ICD-9/10-CM and CPT-4 or ASA classification systems, and regulatory agency requirements related to surgical specialties.

  • Advanced knowledge of CCI, LCD and CMS PRVU, payer-editing systems such as McKesson required. Preference for knowledge related to system integration

  • Computer literacy with knowledge of computerized billing system and healthcare statistics computation required

  • Excellent written and verbal communication skills in order to effectively resolve conflicting views and issues and mediate fair solutions

  • Ability to work with diverse internal and external constituencies

  • Self-motivated with an ability to take responsibility and perform required tasks independently, as well as in a team environment

  • Remote position after training/onboarding is completed.

Boston Children’s Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

Office/Site Location:WestwoodRegular, Temporary, Per Diem:Regular Remote Eligibility :Full-Time Remote